Drug interactions
Colchicine + Cyclosporine
Severity: Contraindicated
Colchicine and Cyclosporine: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cyclosporine inhibits P-glycoprotein and CYP3A4, both of which clear colchicine, so colchicine exposure rises substantially. Fatal colchicine toxicity and myopathy have been reported with this pairing, and cyclosporine itself can cause myotoxicity and nephrotoxicity.
What this interaction means in plain words
Colchicine and Cyclosporine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Cyclosporine inhibits P-gp efflux and CYP3A4 metabolism of colchicine, increasing its exposure.
What to do
Avoid the combination, and it is contraindicated in patients with renal or hepatic impairment. If colchicine is essential, use a substantially reduced dose per labeling and monitor closely for myopathy, cytopenias and diarrhea.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Colchicine
- Clarithromycin + Colchicine Contraindicated
- Cobicistat + Colchicine Contraindicated
- Colchicine + Ensitrelvir Contraindicated
- Colchicine + Levoketoconazole Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir / ritonavir Contraindicated
Frequently asked questions
Can I take Colchicine with Cyclosporine?
MediHelp rates the interaction as contraindicated. Colchicine and Cyclosporine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cyclosporine inhibits P-glycoprotein and CYP3A4, both of which clear colchicine, so colchicine exposure rises substantially. Fatal colchicine toxicity and myopathy have been reported with this pairing, and cyclosporine itself can cause myotoxicity and nephrotoxicity.
How serious is the interaction between Colchicine and Cyclosporine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination, and it is contraindicated in patients with renal or hepatic impairment. If colchicine is essential, use a substantially reduced dose per labeling and monitor closely for myopathy, cytopenias and diarrhea.
What other medicines interact with Colchicine?
MediHelp also lists interactions of Colchicine with, for example, Clarithromycin, Cobicistat, Ensitrelvir. The full list is on the Colchicine page.
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